Phalanges of the hand are known as finger bones. Phalanges of the foot are known as toe bones. The metacarpals are tiny long bones in the hand that connect the phalanges to the carpals. The metatarsals are short bones in the foot that connects the phalanges to the tarsals.
Interphalangeal joints are the joints between the phalanges. These small joints are typically classified as “proximal interphalangeal joints” (PIP or PIPJ, or joints between the first (proximal) and second (intermediate) phalanges) or “distal interphalangeal joints” (DIP or DIPJ, or joints between the second and third (distal) phalanges).
Abnormalities associated with disruptions of these small joints (such as PIP or DIP joints) are caused by biomechanical abnormalities (for example, where certain tendons, ligaments, and supportive structures of the joint are no longer functioning correctly) or other various injuries (for example, sport injuries).
The PIP joint is a hinge joint that is normally kept in alignment by a soft tissue envelope consisting of joint capsule, the volar plate, collateral ligaments and the central slip. These structures form a tight-fitting “box” with a very narrow joint space. When injuries to this soft tissue envelope occur, they can be either partial or complete and they cause disruption to the collateral ligaments and adjacent structures.
Similarly, when the first metatarsophalangeal joint (MTP) (which is one of the joints in the big toe) is affected by arthritis, for example (such as Hallux Rigidus), the cartilage of the joint becomes damaged which in turn can cause extreme pain and stiffness. To alleviate pain, a fusion operation (arthrodesis) is recommended to totally remove the damaged cartilage and to fuse the two bones that form the joint. The fusion is usually secured by either two fixation devices (for example, screws) or a plate that remain in toe permanently.
There is a need for a small joint repair technique that is simple and is performed by a minimally invasive “all-inside” approach. Also needed is a novel instrument that allows both removal of bone from a small bone (for example, phalanx) and also insertion of a fixation device (for example, implant) into the bone.